Osteoarthritis, currently defined as degenerative joint disease, is essentially the long-term deterioration of the integrity of a joint, including the articular cartilage and bone surfaces. 

Although the suffix “-itis” refers to an inflammatory state, this is considered a misnomer.  Degenerative joint disease radiographically is not an inflammatory condition.  This is the reason “degenerative joint disease” (DJD) is currently being used to describe this condition. 

Clinical features of degenerative joint disease may include crepitus (grinding sound), pain, stiffness, and deformity.  The stiffness associated with degenerative joint disease often goes through a “gelling” period.  What this entails is stiffness upon waking from sleep then, as the person moves around, the stiffness begins to subside. 

There are two main categories of degenerative joint disease: primary and secondary. 

Primary DJD means that the degeneration has no direct link to an incident of trauma or other disease process.  The degeneration has an insidious onset. 

Secondary degenerative joint disease entails a known cause for the onset of the DJD.  This may be the result of trauma or another disease process. 

It is speculated that the main cause of primary degenerative joint disease is dysfunction in motion of the joint.  This includes both too much and too little movement of the joint.  Too much motion of the joint (aberrant motion) occurs with the ligaments around the joint, including the joint capsule, becoming overstretched.  This can result from things such as poor posture or chronic stretching of the joint, such as when someone “pops” their knuckles repetitively. 

This results in deterioration of the integrity of the joint as the joint cartilage receives too much wear, quite similar to having a loose wheel on a vehicle.  The cartilage slowly begins to roughen causing a grinding sound (crepitus), and decreases the shock absorption of the joint.  This, in turn, then leads to greater wear on the joint and increased deterioration.

If a joint is moving too little, degenerative joint disease may set in due to a lack of nutrition to the internal components of the joint.  Since there is no direct blood supply to the inside of a joint, the body relies on motion to allow a transfer of waste product and nutrition across the joint capsule. 

If motion is restricted in a specific joint for a prolonged period of time, the joint is unable to attain nutrition and the joint slowly degrades.  It is for this reason that the health care field does not recommend long term traction unless absolutely necessary. 

This essentially leads us to the conclusion that the best practice to help decrease the risk of degenerative joint disease is to maintain proper joint motion to the best of our abilities.  This entails having proper treatment of injuries with a health-care professional and following an adequate stretching routine. 

By strengthening muscles around a joint whose ligaments have been torn, we are better able to avoid aberrant motion. 

By stretching muscles around a joint that is stiff and having that joint adjusted by a chiropractor, we are better able to maintain the motion needed in the joint for the proper transfer of “waste products” and nutrition for the internal joint. 

Although these steps may not eliminate the risk of degenerative joint disease, they will help to either delay its onset or slow the progression of the disease process.

Dr. Steven Trembecki, D.C. is an exceptionally busy and talented chiropractor working in Brooks, Alberta, Canada.